Before starting BYSTOLIC, tell your healthcare provider about all of your medical conditions, including if you: Have asthma or other lung problems such as bronchitis or emphysema Have problems with blood flow in your feet and legs peripheral vascular disease. Have diabetes and take medicine to control blood sugar Have thyroid problems Have liver or kidney problems Have had allergic reactions to medications or have allergies Have a condition called pheochromocytoma rare adrenal gland tumor Are pregnant or trying to become pregnant.
Talk with your doctor about the best way to treat your high blood pressure while you are pregnant. Are breastfeeding. Are scheduled for surgery and will be given anesthetic agents Have had acute angina symptoms include chest pain or discomfort or an MI heart attack as BYSTOLIC has not been studied in patients with these conditions. Also, to avoid a potentially serious or life-threatening condition, tell your healthcare provider if you are taking or plan to take any prescription or over-the-counter medications, vitamins, or herbal products, including: Certain CYP2D6 inhibitors such as some antiarrhythmics like quinidine or propafenone or certain antidepressants such as fluoxetine or paroxetine, etc.
You could have chest pain or a heart attack. Your doctor may start with a low dose and raise it over time. If you miss a dose, take your dose as soon as you remember, unless it is close to the time to take your next dose. Take your next dose at the usual time. What is High Blood Pressure Hypertension? It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease. The dose of this medicine will be different for different patients.
Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine.
Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Keep from freezing. It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects. Do not interrupt or stop using this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous. This medicine may cause changes in your blood sugar levels.
Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests. Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine.
The results of some tests may be affected by this medicine. This medicine may cause some people to become less alert than they are normally. If this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while taking nebivolol.
Do not take other medicines unless they have been discussed with your doctor. Also, blood will be drawn and stored for possible measurement of drug levels, after 4 and 8 weeks on each drug. Results on each drug will then be compared. If nebivolol is found to cause significantly less fatigue, it would be of substantial importance to the many millions of people who are on life-long beta-blocker therapy, and are living with reduced energy.
At the end of each 4-week treatment period on each drug, subjects will undergo a treadmill stress test using the standard Cornell protocol , complete Quality of Life and fatigue questionnaires, and have blood drawn and frozen for later analysis for drug levels. At the end of 8 weeks of treatment on each drug, subjects will undergo echocardiography and applanation tonometry non-invasive measurement of aortic blood pressure to assess heart function.
At the end of the study, the blinded subjects will be asked which of the two study drugs they preferred, and the extent to which their energy differed between the two drugs. In many, it reduces cardiac output and increases peripheral resistance to blood flow 1. It is well-established that beta-blockers cause fatigue in many patients and reduce exertion tolerance. Every physician knows this, and tacitly accepts that many patients are living with this unwelcome side effect.
A new beta-blocker, nebivolol, has the standard beta-blocking effects, but also produces blood vessel relaxation vasodilation , probably through increased secretion of the vasodilator nitric oxide. Studies indicate that nebivolol, unlike most beta-blockers, does not cause constriction of peripheral blood vessels, and is associated with improved heart function 2.
Studies suggest that it is also less likely to cause fatigue 3. Personal experience is consistent with this, as I have observed marked improvement in energy in patients in whom I have prescribed nebivolol in place of a different beta-blocker. The possibility of placebo effect of course cannot be excluded.
Nevertheless, the known hemodynamic differences between nebivolol and other beta-blockers, and the positive clinical experience, warrant formal study to determine whether nebivolol is kinder than other beta-blockers in terms of the important side effect of fatigue.
The participants then received Metoprolol at a dose of 50 mg daily for 4 weeks, followed by mg daily for another 4 weeks i. Other Name: Bystolic Experimental: Metoprolol, followed by Nebivolol Participants first received Metoprolol at a dose of 50 mg daily for 4 weeks, followed by mg daily for another 4 weeks i. The participants then received Nebivolol at a dose of 5 mg daily for 4 weeks, followed by 10 mg daily for another 4 weeks i.
Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies Nebivolol Versus Metoprolol: Comparative Effects on Fatigue and Quality of Life The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
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